Thyroid Removal

Surgery is only necessary for certain findings or certain combinations of findings. There are also differences in how the operation is performed. One can either remove only parts of the thyroid gland (=lobectomy) or the whole thyroid gland (=thyroidectomy).

The ear, nose and throat doctor is often responsible for this, as he or she has the most experience in performing operations in the neck area. The operation is usually associated with a two to three day stay in hospital. In most cases it is patients with nodes in the thyroid gland who have to undergo surgery.

So-called “cold” nodules almost always have to be removed, as they must necessarily be examined under a microscope because they could be malignant, although this is rarely the case. However, if the suspicion is confirmed, a complete removal of the thyroid gland is indicated, as this is the only way to guarantee the complete removal of the tumor and to reduce the risk of recurrence (=reappearance) as much as possible. The “warm” or “hot” nodules are usually removed if they impair the function of the thyroid gland and the thyroid function can no longer be controlled by medication.

Even if the enlargement causes discomfort when swallowing or if it affects neighbouring organs such as the windpipe, removal should be considered. Compulsion to clear the throat or the constant feeling of a foreign body in the throat are also often the reason why patients decide to have surgery. An important alternative to surgery is radioiodine therapy.

Here, the thyroid gland is slowed down by swallowing a capsule of radioactive iodine, which mainly damages the very actively producing cells, since these absorb most of the radioactive substance. Whether surgery, radioiodine therapy or even sole medication is considered depends on the individual case and must be decided individually for each patient.The most serious consequence of thyroid surgery, especially complete removal, is the loss of your function. Since the hormones of the thyroid gland are vital, they must be replaced in tablet form.

If they are replaced in too small a quantity, our physical development and performance as well as our entire mental well-being are impaired. The hormones must be taken in the correct dosage for the rest of life, which requires regular checks by taking blood samples. Vocal cord paralysis is also very much feared, because the nerve responsible for the vocal cords (lat.

: laryngeal recurrens nerve), which controls them, runs right through the surgical area along the thyroid gland. Although the nerve is very carefully protected and closely monitored during the operation, damage cannot be ruled out that would result in temporary or permanent paralysis of the vocal cords. For the affected person, this means a permanently hoarse voice and the loss of the ability to sing.

In very serious cases, where both nerves (right and left side of the neck) are affected, breathing difficulties can be the consequence, because the vocal folds cannot open anymore due to the paralysis. A laryngoscopy can then provide clarity about the findings. The parathyroid glands are also structures that must be carefully observed during the operation.

These 4 small corpuscles sit on the thyroid gland, separated only by a thin layer of tissue. They produce the so-called parathyroid hormone, which influences the potassium metabolism of our body. If they are removed during the operation, the calcium balance is completely disrupted and muscle cramps or tingling in the arms or legs can occur.

Similar to the thyroid hormones, however, the parathyroid hormone can also be taken in tablet form. Swelling of the neck, pain in the area of the thyroid gland and pain when pressure is applied to it, redness and overheating: all these can be signs of thyroiditis (=lat. :thyroiditis; the suffix -itis describes the inflammation).

Inflammation of the thyroid gland is one of the rare diseases of the thyroid gland. However, not all inflammations are the same, there are also different forms. The classification is based on various criteria.

On the basis of the chronological course of the disease, a distinction is made between acute, sub-acute or chronic thyroiditis. Acute inflammation begins very suddenly. It is usually caused by infectious agents such as bacteria or fungi, which become stranded in the bloodstream in the well perfused thyroid gland and lead to inflammation.

In most cases, those affected report a previous infection such as tonsillitis, followed by increasing swelling and pain in the thyroid gland. The affected areas of the neck are reddened and patients complain of difficulty swallowing, fever and the feeling of illness. Irradiation as part of tumor therapy or certain medications also lead to inflammation of the thyroid gland.

The less sudden form (subacute thyroiditis) is probably caused by viruses such as the mumps or measles virus. The course of the disease is variable and can vary from no symptoms at all to the extent of the acute form. The magnification is usually kept within limits.

It usually begins up to two weeks after the infection and patients complain of fatigue and exhaustion. The long-lasting chronic form is usually triggered by autoimmune diseases, i.e. the body no longer recognizes the thyroid gland as a part of itself and starts to fight it like any “enemy” with markers (so-called antibodies). The antibodies mark the apparently foreign tissue and various body cells then lead to the destruction of these structures, which are marked as foreign, according to their mission.

The best known of these autoimmune diseases is Hashimoto’s thyroiditis. The inflammation progresses very slowly and the affected persons often only become aware of their disease due to the increasing hormone deficiency. Very rarely an HIV disease is also the cause of the chronic inflammatory reaction.